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General NPI Number Information
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NPI Number | 1902056138
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Entity Type | Individual
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Provider Name | JAMES EDWARD COWGER JR. APN
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Gender | Male
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 06/26/2012
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Provider Practice Location Address
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Address Line | 929 STACEY BURK DR
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City | FLORA
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State | IL
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Zip | 62839-3241
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Country | US
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Telephone | 618-662-2191
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Fax | 618-662-8090
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Provider Business Mailing Address
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Address Line | 929 STACEY BURK DR PO BOX 40
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City | FLORA
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State | IL
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Zip | 62839-3241
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Country | US
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Telephone | 618-662-2191
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Fax | 618-662-8090
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 000593533
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041.336590
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2007005874
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.009553
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License Number State | IL
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